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| CASE REPORT |
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| Year : 1984 | Volume
: 32
| Issue : 3 | Page : 177-178 |
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Extra orbital venous varicosity : Case report
G Baskara Rajan, A Swaminathan
Dept, of Ophthalmology, Madurai Medical College, Madurai, India
Correspondence Address:
G Baskara Rajan
Dept, of Ophthalmology, Madurai Medical College, Madurai
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 6519734 
How to cite this article:
Rajan G B, Swaminathan A. Extra orbital venous varicosity : Case report. Indian J Ophthalmol 1984;32:177-8 |
Orbital varix is a rare clinical curiosity usually occurring unilaterally synonymous with intermittent proptosis.[1],[2],[3],[4],[5],[6],[7],[8],[9] Extra orbital varix is still more rare. 12 We are reporting a case of isolated extra-orbital Varicosity, occurring in the upper inner quadrant of right orbit along the superior Ophthalmic vein. The case is reported because of its rarity.
| Case report | |  |
Miss M. aged 21 years, complained of an intermittent swelling in the upper and inner quadrant of right orbit, which became prominent and painful while stooping forwards for a few minutes. The swelling had gradually increased in size over a period of 10 years. The vision and fundus were normal and the re was no other ocular abnormality. On Valsalva manouvre, the swelling became obvious [Figure - 1]. No history of injury prior to the onset of the swelling could be elicited. She had not attained menarche. There was no other vascular abnormality in other parts of the body. Rudimentary development of external genitalia. was revealed by gynaecological examination.
An orbital venography was performed by a direct puncture into the swelling itself. The pictures were taken in postero anterior and lateral views. The pooling of dye was found to be at the junction of supra-Orbital vein, frontal vein and angular vein [Figure - 2]. The mass was excised under local anaesthesia, after ligating the feeder channels [Figure - 3].
Histopathological examination showed, thickening of the muscular layer with increase in number of Vasa-Vasorum [Figure - 4].
| Discussion | | |
There are syndromes like KLIPPELTRENAUNAY-WEBER SYNDROME when orbital varices can be associated with varicosity of the limbs, accompanied by cutaneous navei. Presence of varices in buccal mucosa in uvula and soft palate, in the upper and lower limbs the side of neck, the face and association with the orbital varices have been reported. In 4 of the 12 cases reported by Lloyd and his colleagues orbital varices were associated with venous malformations outside of orbit.[6]
Trauma can induce venous varicosity.[3] In this case there was no history of trauma. The venous dilatation had occured in the junction of the various veins of the orbit. Since these veins act as emissary veins, they have no valves and the blood flow can occur freely even if there is any obstruction in any of the veins. So congenital predisposition is a probable cause. Non attainment of menarche appears to be a coincidence put the hormonal imbalance might have increased the elasticity of the vessel wall. As proved by histopathological examination the venous wall showed thickening and increased vascularity. This is due to compensatory hypertrophy of the vessel wall due to recurrent congestion.
| Summary | | |
A case of extra orbital venous varicosity is reported in a young female. Various communicating veins have been demonstrated venographically. Surgical procedure and histopathological changes in the veirs are described.
| References | | |
| 1. | Baskararajan,_G. 1977. Madras State Ophthalmol Assoc 15: 81  |
| 2. | Brockhurst, R.J. 1977. Controversy in Ophthalmology p 343-360 Saunders, Philadelphia |
| 3. | Duke-Elder. S 1974. System of Ophthalmology Vol.13 Part II p 825 Henry Kimpton, London |
| 4. | Henderson J.W. 1973. Orbital Tumours p. 174-179 Saunders, Philadelphia |
| 5. | Jain, B.S. and Srivastava, K.N. 1964. Brit. I Ophthalmol, 48: 232 |
| 6. | Lloyd, G.A.S. and Wright, J.E. 1970. Tos UK XC: 245 |
| 7. | Lombardi, G & Passerini, A 1967. Amer 1. Ophthalmol 64: 440 |
| 8. | Rathbun, J.E. 1970. Amer J. Ophthalmol 70: 109 |
| 9. | Baskararajan, G. 1981. Indian Paediatrics 18: 74. |
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]
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